Chemotherapy is the use of anticancer drugs that work in a number of ways to eradicate cancer cells, either by killing the cells directly or stopping them from dividing.
Common chemotherapy combinations used for ALL are:
- Traditionally, vincristine, an anthracycline drug (such as daunorubicin, doxorubicin, or idarubicin) and a steroid (dexamethasone and prednisolone) to help improve the effectiveness of the chemotherapy are used as induction therapy.
- A number of other drugs can be added to this combination depending on the patient’s characteristics and response to treatment:
- Cyclophosphamide or cytarabine, if required
- Asparaginase or pegaspargase (a derived version of asparaginase)
- A tyrosine kinase inhibitor (TKI), such as imatinib, for patients who are Philadelphia chromosome.-positive as TKIs target the BCR-ABL1 protein within the Philadelphia chromosome.
- A target therapy drug such as an immunotherapeutic monoclonal antibody cells may be added. A target therapy drug is a drug developed to target specific components of the leukaemia.
- In elderly patients (60 years or older), standard treatment with intensive chemotherapy can achieve CR rates of 80%, but up to a third will die of complications due to bone marrow suppression when they receive consolidation or maintenance treatment.
- Age-adapted treatment protocols with less intensive treatment have been developed for elderly patients.
- Low‑intensity HCVD regime (hydrogenated cyclophosphamide, vincristine, dexamethasone) and inotuzumab ozogamicin can achieve complete remission with reduced toxicity in 75% of these patients.
- Less intensive treatment of vincristine, corticosteroids, and asparaginase is also effective,
